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March 1987

Generalized Blistering Eruption Aggravated by Heat

Author Affiliations

Stanford (Calif) University (Drs Rodan, Fleischmann, and Nickoloff), Palo Alto (Calif) Veterans Administration Hospital (Dr Egbert)

Arch Dermatol. 1987;123(3):395-396. doi:10.1001/archderm.1987.01660270133033

REPORT OF A CASE  A 40-year-old man with a generalized skin eruption was referred to the dermatology service at the Palo Alto (Calif) Veterans Administration Hospital. Seven months prior to admission, during an emotionally stressful period, the patient noticed a nonhealing tender red patch on the preauricular region of the left side of his face. In the following five months, similar lesions appeared, remaining localized to the head and neck, and later becoming generalized to all areas but the mucous membranes.According to the patient, disease exacerbation was precipitated by sun and heat exposure. Burning, pain, and skin tightness were his primary symptoms. He was otherwise in excellent health and was taking no medications prior to the onset of his skin disease.Skin examination revealed rare flaccid bullae, large areas of superficial denudation, and serpiginous, erythematous patches with an overlying loosely adherent yellowish thin crust (Fig 1). Nikolsky's sign was positive. No oral or genital lesions were

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